Archives for October 2017

I have been unhappy with a gap between my two front teeth for years, and my dentist recommended that I have cosmetic bonding done to correct it. I was a little wary of it at first because I didn’t want to damage my teeth, but he assured me that it wouldn’t really impact the teeth at all- that he was basically just adding onto them and not taking anything away. It seemed like this would be less invasive than porcelain veneers, which he pitched to me a few years ago, so I decided to give it a go.

The procedure was totally uneventful. I can’t think of anything that happened during it that could have caused an issue. I was in the office for less than an hour and my teeth looked good after the cosmetic bonding was done. However, about a month or so after, the tooth on the right started to feel strange. I wouldn’t call it painful, but it wasn’t normal. I guess I’d say I mostly became “aware” of it, if that makes any sense. I called the office and asked about it and they told me that it was normal- that sometimes the nerves become agitated or irritated when a tooth is worked on- and that I should take ibuprofen until it settled down again. I did that for about two weeks, but in that timespan, it actually started hurting, especially when I ate something cold. I called the dentist again, and they still told me it was normal, and to keep giving the tooth time to rest. Well, this past week, the tooth developed an abscess, and I had to go in and get it looked at. To be clear, this was a normal and healthy tooth prior to the cosmetic bonding. I had no problems with it beforehand. Now, I’m on antibiotics and need a root canal and crown.

I asked the dentist if the procedure caused the problem. He told me that the nerve was dead or dying prior to it, and that the work may have pushed it over the edge, but that it was bound to happen anyway. I’m not buying it. I think he caused the problem. Was it the procedure or was my tooth dead/ dying and non-symptomatic beforehand?

Thanks,

Palma

Dear Palma,

It’s tough to say. Cosmetic bonding, particularly in the type of application you reference, really is minimally-invasive. It’s usually when there’s a large cavity or a large amount of the tooth structure is gone that the nerve and pulp react. In your case, if the tooth was prepped right and there was no decay there, almost none of the natural tooth structure should have been impacted. However, sometimes teeth don’t respond well to the vibrations of the handpieces, even when polishing, though this is incredibly rare.

If you felt pain after, the tooth wasn’t dead at that point, but your description of the symptoms does make it sound like it was in the process of dying, and that is irreversible. Sensitivity could be normal, but it sounds like you experienced a bit more than that. At the same time, teeth can die and be totally asymptomatic for some time. For example, if you experienced any kind of trauma or hit your teeth on something, you might not experience and issue for months or even a year or more after. It’s not until bacteria has a chance to thrive that the abscess would form.

In other words, your dentist was probably right. The tooth probably had something going on beforehand, but didn’t display the common symptoms. You could possibly take before and after x-rays to another dentist to confirm this and see if your dentist missed something, but there’s a very real possibility this one was out of his hands.

I’m wondering what matters more, the direct composite veneers technique or the dentist’s personal preference. I’m based in the US and have been looking over this site. The before and after photos look amazing. I think I’d probably be a good candidate for the procedure because I’m looking for a non-invasive way to close the gap between my front teeth. I’ve been seeing the same dentist for 10 years, and he and I have a friendly relationship, so I showed it to him the last time I was in his office. He says he can fix the gap, but he’ll only do it with full porcelain veneers. I’m not really sure I’m up for all that. I don’t want my teeth grinded down. I’m really torn. Should I skip having the work done altogether, keep pushing for the in-office option, or let the dentist do what he’s recommending?

Thank you,

Javier

Dear Javier,

Using a direct composite veneers technique that includes a matrix can make the process easier on the dentist. A lot of cosmetic dentists prefer it because it gives them the shape they need with little effort, and they get a nice symmetrical result every time. However, like any other skill, there’s always a learning curve. The dentist has to learn how to use the technology and really become comfortable with it before he produces beautiful results like you see in the Smile Gallery here.

It sounds like your dentist isn’t comfortable with this type of procedure. That’s a shame because what you’re trying to accomplish doesn’t really require the use of porcelain, particularly due to the fact that you’re intentionally seeking out minimally-invasive options.

What you choose to do here is a very personal decision. You aren’t likely to make any headway if you try to push the doctor into doing something he’s not comfortable with, and it could even be worse if he caves in and tries to do it for you without spending time becoming familiar with the process anyway. For this reason, you have three reasonable choices.

Skip the procedure or hold off on it until you feel comfortable with one of the other options.

Let the dentist use the materials and procedures he’s most comfortable with.

Find a dentist who already performs the procedure you want. In this case, you’ll specifically want to look for a cosmetic dentist.

Only you can decide what’s best for you, but do take this into consideration as you make a choice. Best of luck to you.

This blog is sponsored by Uveneer. To learn more about how Uveneer can simplify your direct composite veneers technique, check out the video page.